AccountId: 011433970860
ContactId: 95539d62-3038-45b3-aefb-eed49fef0aa9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257579 ms
Total Talk Time (AGENT): 118982 ms
Total Talk Time (CUSTOMER): 67178 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/95539d62-3038-45b3-aefb-eed49fef0aa9_20250325T18:55_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from prior office to check the claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Only one?
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, best callback number is [PII].
[AGENT][NEUTRAL] And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02002986 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The name is [PII] with the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to look at?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] And the total bill?
[CUSTOMER][NEUTRAL] Total bill is $11,325.80.
[AGENT][POSITIVE] Thank you for that. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the policy that you provided um was active from [PII].
[AGENT][NEUTRAL] There is a policy that was active on your data service, um, that's policy number 246-7658.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm going to check both policies though to to look for the claim, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] Mar.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was $11,325.80.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment. And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] HCA Florida Poniana Hospital.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Alright, so the claim is under the new policy number and we received it on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that claim number is 3559451.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and how we can submit that?
[AGENT][NEUTRAL] Um, you can fax it, you can mail it, or you can send it electronically. Um, which one would you prefer? I can provide you with the information.
[CUSTOMER][NEUTRAL] Uh, fax number?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 942. OK, thank you. And what will be the time filling limit?
[AGENT][NEUTRAL] So there's no timely filing limit as long as the policy was active on the data service, you can file at any time.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Just provide me the caller reference number, please.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you. Thanks for assisting me today, [PII].
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, nothing else.
[AGENT][POSITIVE] All right, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye.